5 steps to help save a knocked-out tooth with emergency dental care

Having a tooth knocked out of your mouth or even a tooth knocked loose is a scary event. Most of the time, there is an accident or trauma involved, and there may be other serious injuries for you to deal with. Mouth and facial injuries that are powerful enough to knock out a permanent tooth mean that other oral and facial structures, such as the gums, lips, tongue, or cheeks, may also need emergency care. 

A trip to the emergency room can be costly and intimidating. If your face, throat, or eyes are also hurt, a trip to the emergency room might be unavoidable. Sometimes treatment at an ER is necessary but not always, depending on why your tooth fell out.

When a permanent tooth is knocked loose

If there are other serious injuries or loss of consciousness, head straight to the emergency room. The avulsed tooth might be the least of your worries. At the ER, the doctors will X-ray your injuries and do other diagnostic tests to evaluate not just your mouth but the rest of your body. Most hospitals have dentists on call for oral and facial emergencies, and they may call in their staff dentist to evaluate your mouth and teeth.

If the tooth seems to be the only injury, taking steps to quickly address the problem will mean the difference in saving or losing the tooth permanently. With proper emergency treatment, a dentist may be able to replant a permanent tooth back into its socket.

For replanting of a permanent tooth to succeed, you must act quickly. See a dentist within 30 minutes of the accident, if possible. If you can find the tooth, take these important steps:

1. Pick the tooth up by the top (the part that chews) but not the root

2. If the tooth is dirty, rinse it with water. Do not use any sort of soap or chemicals like hydrogen peroxide or alcohol. Do not scrub the tooth or try to dry it off, and do not wrap the tooth in any type of dry tissue or cloth.

3. If possible, place the tooth, root first, back into the socket. Gently push the tooth into the socket and slowly close your mouth. Keep the tooth in place by gently biting on it or hold it steady with your finger.

4. If you cannot replant the tooth into its socket, keep the tooth moist until you can get to a dentist or ER. Milk is the best liquid to keep the tooth wet. If no milk is available, try placing the tooth next to your cheek inside your mouth while you find a dentist or ER to provide treatment.

5. Bring the tooth with you to the dental office. It is best to see a dentist or endodontist within 30 minutes of the injury. But, if this is not possible, it is still possible to save the tooth, even after being out of the mouth for an hour or more. 

Because of the damage to the nerves and blood supply to a tooth that has been knocked out, your dentist or endodontist may have to provide root canal therapy for the replanting to succeed.

They may also have to splint the tooth to the strong adjacent teeth to keep it stable during the healing process, even for a permanent tooth knocked loose. But the bright side is that the tooth will eventually reattach to the gums and bone and function like a normal tooth for many years. 

If a tooth receives a forceful blow during an injury but does not come completely out of its socket, the tooth will most likely reattach itself to the gums and bone over time. Most teeth knocked loose will tighten back up. Likewise, a dentist may be able to move a tooth that has been knocked out of position back into its proper place. Eventually, the tooth will grow back into its normal position in the mouth. 

When baby teeth are knocked out too soon

Children normally keep their baby teeth until around the age of 12. If you are a parent, you know how often children fall and have accidents on the playground as well as inside the home. 

Baby teeth are important because they serve as pathways for the permanent teeth to follow during growth and eruption. If a baby tooth is knocked out prematurely—before the permanent tooth grows in enough to push the baby tooth out naturally—it is important that you see a dentist as soon as possible. 

Although a dentist will not replant a baby tooth, they may want to make your child a space maintainer to keep the other teeth from drifting into the space and to help continue guiding the permanent tooth into its proper place. Without a means to keep the space open for the permanent tooth to grow into, the teeth on either side of the space could tilt inward, blocking the permanent tooth from growing properly. Also, without the roots of the baby tooth to serve as guides, the permanent tooth, which is still growing underneath the gums, could start to tilt and grow in a path that is not in line with the other teeth.

If the top of a baby tooth breaks leaving the root in place, you also need to see a dentist as soon as possible, as they may need to remove the roots to prevent infections or toothaches.

There are many factors that a dentist considers when deciding what treatment to provide when a child loses a baby tooth early or has a baby tooth knocked loose. The child’s age, their stage of dental development, the severity of the injury, and if the tooth is in the front or back all play into a dentist’s decision about how to treat your child. 

Baby teeth have shallow roots, unlike permanent teeth. Even if a baby tooth is knocked completely out, there is little chance of any permanent damage, especially if you see a dentist right away. 

How do teeth get knocked out?

According to the American Academy of Endodontists (AAE), more than five million teeth are knocked out every year1. 

There are a lot of different ways that teeth are knocked out. Any sort of forceful blow to the front of the face, nose, or cheeks can loosen, move a tooth out of place, or knock a tooth totally out of its socket.

Car accidents and contact sports are among the most common causes of knocked out teeth. If a car accident is involved, a trip to the ER is probably required to rule out more serious injuries. Depending on the extent of an injury that occurs playing baseball, basketball, rugby, or other contact sports, these might also warrant an ER visit. If no other injuries are apparent, your local dental office or clinic could be your best and least expensive option for treatment.

Other events that might cause a tooth to be knocked out include falls of any kind, bicycle or motorcycle wrecks, fights, or playground accidents. In adults, advanced gum disease can undermine the supporting gum and bone structures that hold a tooth in place, and something as simple as eating a piece of sticky or hard candy can cause a tooth to fall out.

How dental insurance helps you cover emergency dental care costs of a knocked-out tooth 

If you do not have access to an employer-sponsored dental insurance plan, there are other options to get dental coverage.

Traditional dental insurance requires a monthly premium, deductibles, and copays but the dental office bills the insurance company directly for their fees. 

Preventing teeth from being knocked out

Preventing dental injuries that cause teeth to be knocked out is important for people both young and old. Here are a few tips you can follow to minimize the risk of accidents or injuries that might cause you to lose a tooth. 

Mouth guards

One of the most common causes of a tooth being knocked out is sports injuries. Mouth guards can be an effective way to prevent many sports injuries. Mouth guards provide a cushion for the teeth, lips, tongue, cheeks, face, and jaws. They are inexpensive and can prevent serious injuries. 

Helmets

All children and adults who ride bicycles, scooters, four-wheelers, motorcycles, segues, and other forms of open-air recreational vehicles should wear helmets any time they are riding. These not only prevent teeth from being knocked out but also prevent serious brain injuries.

Fall prevention

For toddlers, preventing falls is almost impossible. Close supervision of any small child as they learn to walk is the best way to prevent the little ones from falling and causing oral trauma. For older children and adults, using step ladders, keeping floors clear of clutter, wearing non-slip shoes, and providing adequate lighting are all measures that will help prevent falls that result in dental injuries.

Seat belts

Seat belts for adults and car seats for children provide proven methods for preventing serious injuries during both dangerous car wrecks and minor fender benders. Buckling up should be a part of every person’s normal routine when preparing to drive or ride in a car.

Oral hygiene habits

Adults who have advanced gum disease can have teeth knocked out during simple tasks that do not involve an injury. Eating hard foods or sticky candy can cause a tooth with serious gum disease to come out. Accidentally bumping into a doorway or using the teeth inappropriately as tools (biting a piece of string, for example) can cause a tooth loosened by gum disease to come out. 

Daily brushing and flossing remove harmful bacteria and sticky food debris from the teeth. If those substances are allowed to stay on the teeth, they eventually cause the gums and bone that serve as anchors for the teeth to deteriorate. When this happens, the teeth become loose in their sockets and can be easily knocked out. Preventing gum disease by practicing good daily oral hygiene habits ensures that the teeth remain stable and well attached to the jawbone.

Keeping your teeth healthy and safe

Practicing good oral hygiene, keeping the teeth and gums healthy and clean, wearing mouth guards during sports, wearing helmets and seat belts when riding in or operating a motor vehicle, and practicing fall prevention methods helps to prevent dental injuries that might result in knocking a tooth out. But if you do experience an avulsed tooth, do not panic. See a dentist right away. 

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Material discussed is meant for general illustration and/or informational purposes only and it is not to be construed as tax, legal, investment or medical advice. It is not dental care advice and should not be substituted for regular consultation with your dentist. If you have any concerns about your dental health, please contact your dentist's office.